Immigrant populations, work and health—a systematic literature review

Objectives This paper summarizes the information on immigrant occupational health available from recent studies, incorporating varied study designs. Methods A systematic search was carried out in PubMed employing terms of interest to the study and related terms supplied by the same search engine. Articles were selected through the following process: (i) reading the title and abstract, in English or Spanish, for the period 1990–2005, (ii) reading of the entire text of selected articles; (iii) making a manual search of the relevant citations in the selected articles; (iv) eliminating articles without a focus on the themes of central interest (immigration, work, and health), and (v) reading and analyzing the definitive article set. No quality criteria were used in the article selection. Results The location of studies was not straightforward and required careful thought about the search terms. The included 48 papers were often multifaceted and difficult to categorize. They generally came from countries historically associated with immigration and described occupational risk factors, health consequences, and the social, economic, and cultural influences on worker health. They were also based on data, surveillance, training, and preventive measures that were inadequate. Conclusions Increased migration is a reality in industrialized countries all over the world, and it has social, political, and economic consequences for migrating groups, as well as for their sending and host societies. More reliable data, targeted appropriate interventions, and enforcement of existing regulations are necessary to improve the health of immigrant workers. Furthermore, studies in sending and developing countries should be encouraged to form a more complete understanding of this complex situation

Flynn et al. Respond

Comment on Work as an Inclusive Part of Population Health Inequities Research and Prevention. [Am J Public Health. 2018] New Horizons for Occupational Health Surveillance. [Am J Public Health. 2018

Development and testing of an implementation strategy for a complex housing intervention: protocol for a mixed methods study

Background: There is currently a lack of scientifically designed and tested implementation strategies. Such strategies are particularly important for highly complex interventions that require coordination between multiple parts to be successful. This paper presents a protocol for the development and testing of an implementation strategy for a complex intervention known as the Housing First model (HFM). Housing First is an evidence-based practice for chronically homeless individuals demonstrated to significantly improve a number of outcomes. Methods/design: Drawing on practices demonstrated to be useful in implementation and e-learning theory, our team is currently adapting a face-to-face implementation strategy so that it can be delivered over a distance. Research activities will be divided between Chicago and Central Indiana, two areas with significantly different barriers to HFM implementation. Ten housing providers (five from Chicago and five from Indiana) will be recruited to conduct an alpha test of each of four e-learning modules as they are developed. Providers will be requested to keep a detailed log of their experience completing the modules and participate in one of two focus groups. After refining the modules based on alpha test results, we will test the strategy among a sample of four housing organizations (two from Chicago and two from Indiana). We will collect and analyze both qualitative and quantitative data from administration and staff. Measures of interest include causal factors affecting implementation, training outcomes, and implementation outcomes. Discussion: This project is an important first step in the development of an evidence-based implementation strategy to increase scalability and impact of the HFM. The project also has strong potential to increase limited scientific knowledge regarding implementation strategies in general

Occupational health of immigrant workers in Spain (ITSAL Project): key informants survey

Objetivo: Caracterizar colectivos de inmigrantes trabajadores en España y conocer sus condiciones de salud laboral mediante informantes clave. Método: Estudio cualitativo exploratorio-descriptivo con entrevistas en profundidad realizado en 2006. Se identificaron organizaciones, asociaciones y colectivos relacionados con la población inmigrante en Alicante, Barcelona, Huelva, Madrid y Valencia, y se seleccionaron los más accesibles y representativos. Se entrevistó a 43 informantes clave procedentes de 34 asociaciones u organismos. Se realizó un análisis narrativo del contenido. Resultados: Se señalan dificultades para el reconocimiento de los daños a la salud derivados del trabajo por las situaciones de irregularidad y precariedad, por resistencia por parte de los contratadores o las entidades aseguradoras, y por desconocimiento de los inmigrantes. Los informantes coinciden en que los riesgos laborales en los inmigrantes no difieren de los riesgos de los trabajadores autóctonos en similares circunstancias, pero los inmigrantes padecerían exposiciones más frecuentes e intensas por el acceso mayoritario a puestos menos cualificados y por la necesidad de prolongar las jornadas de trabajo. También se destaca su desconocimiento general en relación con los derechos de protección y de salud en el trabajo, aunque algunos informantes detectan un crecimiento de su actividad reivindicativa a través de los sindicatos. Conclusiones: Este primer acercamiento ha permitido definir algunos condicionantes generales que influirán en la salud laboral de los inmigrantes. La información obtenida servirá de base para profundizar, mediante técnicas adicionales de carácter cualitativo y cuantitativo, en los problemas de salud laboral de los inmigrantes trabajadores en España dentro del marco del Proyecto Inmigración, Trabajo y Salud (ITSAL), actualmente en desarrollo.Objective: To describe the characteristics, working conditions, and occupational health situation of immigrant workers in Spain through key informants. Method: We performed a qualitative, exploratory and descriptive study using indepth interviews carried out in 2006. Organizations and associations working with immigrant collectives in Alicante, Barcelona, Huelva, Madrid and Valencia were identified and the most representative and accessible entities in each location were selected. Fortythree interviews were performed with key informants from 34 different organisms. A narrative content analysis was performed. Results: Informants described difficulties in having health problems recognized as workrelated, due to irregular and precarious employment, employers' and insurance companies' reluctance, and immigrants' lack of knowledge. Informants coincided in reporting that the occupational risks for immigrant workers did not differ from those affecting Spanish workers in the same occupations and circumstances. However, exposure to occupational risks was exacerbated in immigrants because of their greater presence in unqualified jobs and their economic need to prolong working hours. Immigrants had little knowledge of their occupational health and safetyrelated rights, although some informants detected an increase in empowerment in this area, mostly through greater participation in trade unions. Conclusions: This first step allowed us to identify some of the general factors influencing the health and safety of immigrant workers in Spain. This information will be used in a longterm, ongoing research project [Project Immigration, Work and Health (Proyecto Inmigración, Trabajo y Salud [ITSAL]), which aims to evaluate occupational health problems in inmigrants working in Spain through both qualitative and quantitative methods

Initiatives addressing precarious employment and its effects on workers’ health and well-being: a protocol for a systematic review

Precarious employment is a significant determinant of population health and health inequities and has complex public health consequences both for a given nation and internationally. Precarious employment is conceptualized as a multi-dimensional construct including but not limited to employment insecurity, income inadequacy, and lack of rights and protection in the employment relation, which could affect both informal and formal workers. The purpose of this review is to identify, appraise, and synthesize existing research on the effectiveness of initiatives aiming to or having the potential to eliminate, reduce, or mitigate workers’ exposure to precarious employment conditions and its effects on the health and well-being of workers and their families

Risk of fatal and non‐fatal occupational injury in foreign workers in Spain

dramatic growth of its immigrant population. Available information on the occupational conditions of foreign work-ers is scarce. This study aims to add to this information by describing occupational injuries in foreign workers in Spain. Design, setting, participants: Data were analysed from the 2003 Ministry of Labour and Social Issues registry of non-fatal and fatal occupational injury in insured workers. The population at risk was estimated from the Social Security Affiliation Registry as of 31 December 2003. Comparing Spanish with foreign workers and also considering age and sex, incidence rates and relative risks, and their confidence intervals at 95%, were calculated within each population group. Main results: In women and in men, and in every age group, foreign workers had an increased risk of non-fatal and fata

Negative mood states and related factors in a sample of adolescent secondary-school students in Barcelona (Spain) Estados de ánimo negativos y los factores relacionados en una muestra de adolescentes de enseñanza secundaria de Barcelona

Introduction: Poor mental health is a common problem in adolescence. Little information is available, however, about the factors influencing negative mood states in otherwise healthy adolescents. We aimed to describe the mood states and related factors in a sample of adolescents in the city of Barcelona (Spain). Methods: We administered a health survey to a sample of 2,727 students from public, subsidized, and private schools in Barcelona, aged approximately 14, 16, and 18 years old. To analyze the associations among moods and related factors, we used bivariate logistic regression, and fitted multivariate logistic regressions using the statistically significant variables from the bivariate analysis. To examine the possible group effects of the school on individual students, we employed multilevel analysis. Results: The frequencies of negative mood states increased with age, with girls consistently reporting more frequent negative mood states than boys. The factors associated with negative mood states were problematic alcohol use, perceived mistreatment or abuse, antisocial behavior, intention to use or current use of illegal drugs (not including cannabis), lower perceived academic performance, and feeling isolated. Conclusions: Mood states are influenced by lifestyle and social factors, about which there is little local information. To plan and implement appropriate public health interventions, more complete information about the possible areas of influence is required. To complement the information obtained from studies such as the present study, longitudinal and qualitative studies would be desirable.<br>Introducción: El deterioro de la salud mental es un problema frecuente en la adolescencia. Sin embargo, se sabe poco de los factores influyentes en los estados de ánimo negativos en adolescentes saludables. Pretendemos describir los estados de ánimo negativos y los factores relacionados en una muestra de adolescentes de la ciudad de Barcelona. Métodos: Administramos una encuesta de salud a 2.727 estudiantes de escuelas públicas, concertadas y privadas en Barcelona con edades de 14, 16 y 18 años. Usamos análisis regresión logística bivariada para estudiar las relaciones entre los estados de ánimo negativo y los factores relacionados, para ajustar después un modelo logístico multivariante con los factores significativos del análisis bivariado. Para examinar la posible influencia de los factores grupales de los centros escolares en los individuos, hemos empleado el análisis multinivel. Resultados: Las frecuencias de los estados de ánimo negativos aumentaban con la edad, y las chicas consistentemente relataban estados de ánimo peores que los chicos. El uso problemático del alcohol, el abuso y el maltrato percibido, las conductas antisociales, la intención de usar o el uso actual de drogas ilegales, el bajo rendimiento escolar percibido y el sentirse marginado se relacionaron también con estados de ánimo negativos. Conclusiones: Hay factores personales, sociales y de estilos de vida, sobre los que tenemos poca información local, que influyen sobre los estados de ánimo. Para planear e implementar intervenciones de salud pública apropiadas, necesitamos una información más completa sobre las áreas de posible influencia. Para complementar la información obtenida en estudios como éste, sería deseable llevar a cabo estudios longitudinales y cualitativos

Work, Health, and the Ongoing Pursuit of Health Equity

The many facets of work, including employment relationships and attendant employment quality, the day-to-day conditions experienced in any given job, and the evolution of one&rsquo;s working circumstances over time can support or detract from health, and combine in myriad ways to impact worker well-being [...

Alpha test results for a Housing First eLearning strategy: the value of multiple qualitative methods for intervention design

Abstract Background Detailed descriptions of implementation strategies are lacking, and there is a corresponding dearth of information regarding methods employed in implementation strategy development. This paper describes methods and findings related to the alpha testing of eLearning modules developed as part of the Housing First Technical Assistance and Training (HFTAT) program’s development. Alpha testing is an approach for improving the quality of a product prior to beta (i.e., real world) testing with potential applications for intervention development. Methods Ten participants in two cities tested the modules. We collected data through (1) a structured log where participants were asked to record their experiences as they worked through the modules; (2) a brief online questionnaire delivered at the end of each module; and (3) focus groups. Results The alpha test provided useful data related to the acceptability and feasibility of eLearning as an implementation strategy, as well as identifying a number of technical issues and bugs. Each of the qualitative methods used provided unique and valuable information. In particular, logs were the most useful for identifying technical issues, and focus groups provided high quality data regarding how the intervention could best be used as an implementation strategy. Conclusions Alpha testing was a valuable step in intervention development, providing us an understanding of issues that would have been more difficult to address at a later stage of the study. As a result, we were able to improve the modules prior to pilot testing of the entire HFTAT. Researchers wishing to alpha test interventions prior to piloting should balance the unique benefits of different data collection approaches with the need to minimize burdens for themselves and participants